With the major EMR push that the Healthcare sector has seen over the past decade, it's only natural for practices to find themselves with an EMR that just isn't working out. So what's to stop said practice from switching EMRs to a system more condusive to their needs? Most of the time, it's the obvious dillema of 'How can I move my patient records from EMR A to EMR B?'

I'm thrilled to tell you that this is no longer reason to hold off switching. ELLKAY has filled this huge need by offering complete clinical data extraction and conversions, TO and FROM virtually ANY EMR System.

Yes, I agree with you @David about the market naturally shaping EMRs. And I believe incentive programs and the government mandate distorted and created an unnatural market for EMRs, courtesy of MU et al. That said, it's hard to argue that healthcare organizations would have adopted tech without any government action (or interference, as some say). One problem with 'artificial deadlines' is, as we're now seeing, some organizations simply automated manual processes; they didn't use this investment as an opportunity to review, reconsider, and redesign inefficient procedures and create new and better workflows that leverage the full power of automated systems. So you basically have software doing what people have done for decades -- not always the best use of tech or skilled professionals' time.

By "culling the market for health products," do you mean have the government decide which EHRs stay or go, @David? I won't address that point until I'm clearer on the meaning! :)

As to interoperability, while I may be naive here (although after covering tech for 20+ years, it's hard to imagine!), plenty of other industries have accomplished this goal. It may not have been easy. It may not have been painless. But they finally arrived at the point where different vendors' products are interoperable. Customers demanded the capability -- and vendors were forced to comply. Government mandates created an artificial market, where providers were forced to rush into EHR purchases within a prescribed time, creating a fake bubble that allowed EHR vendors to meet only government requirements (eg, MU 1, then 2). Since interoperability was not part of that mandate, they were able to coast on this. And who can blame them.

From providers' POV, many were scrambling to meet government deadlines and focused only on mandate requirements. If a vendor met those needs, then it could be in the list of candidates. Interoperability did not (always) come into it. Of course, now healthcare providers are living with the results -- and we are seeing many switching to alternative providers, sometimes for that reason.

I have to wonder whether the interoperability problem isn't a factor of too many health IT vendors, sustained by government subsidies. Culling the market for health IT products might be the best thing for interoperability. Standards are nice, but it's really hard to make standards so standard that they work without tweaking across a large number of vendors for a wide range of uses. When there are so many different EHRs in use, it's difficult for every vendor to churn out compatibility tweaks for every other vendor -- and we wind up with patchwork, partial interoperability.

True? Or have I been spending too much time talking with Jonathan Bush?

From what I've heard, there are no more financial "carrots" coming to practioners from the government. Now, when it comes to government handing out money, I'd say never say never! It is going to be extremely difficult to change behavior and incentives are certainly one way of encouraging behavior changes. Penalties are the opposite form, and government has used both these forms in healthcare (and other industries) in the past.

Yes: There are financial penalties for HIPAA breaches that affect more than 500 patient records. The government has been penalizing organizations of all sizes which should, I'd imagine, sound a more chilling note to healthcare organizations that they must take HIPAA seriously. I know service providers like HIPAASecureNow have told me more practices are seeking risk assessment services.

Right, but not yet. After all, there are no standards as yet to adhere to. I don't imagine "the stick" will be much of a factor. Once it gets up and running, staying out will turn out to be it's own penalty in many ways.

@Gary_EL so you would use both carrots and sticks? There were programs that offered medical practioners and facilities financial incentives for getting on board with EHR systems, but I don't think there were any penalties for not doing so. Of course, that doesn't mean it is unheard of. I believe HIPPA is enforced with the threat of penalties.

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